Validation of Serum Galactomannan for Invasive Pulmonary Aspergillosis Outcome Prediction

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Objectives: Validation of the serum galactomannan enzyme immunoassay optical density index (sGMI) as a prognostic factor in invasive pulmonary aspergillosis (IPA). Methods: Patients with proven or probable IPA who had a sGMI result between 2013 and 2020 at a tertiary referral center were identified. We conducted a systematic review and identified static or kinetic sGMI prognosis markers for IPA. Logistic regression was used to validate these sGMI markers with our cohort for 30-day, 90-day, and in-hospital mortality. Results: A total of 268 IPA patients was collected. Our systematic review extracted 28 studies and 12 different sGMI predictive markers were included for validation. In our multivariable logistic regression, baseline sGMI ≥2 at IPA diagnosis was associated with 30-day mortality (adjusted odd ratio (aOR) 2.06, 95% confidence interval (CI) 1.16─3.66, p=0.013), 90-day mortality (aOR 2.33, 95%CI 1.29─4.21, p=0.005), and in-hospital mortality (aOR 2.99, 95%CI 1.62─5.51, p<0.001). Day 7 sGMI ≥1.5 was also associated with 30-day mortality (aOR 2.34, 95%CI 1.09─5.02, p=0.029), 90-day mortality (aOR 2.24, 95%CI 1.10─4.58, p=0.027), and in-hospital mortality (aOR 2.30, 95%CI 1.12─4.71, p=0.023). No kinetic sGMI marker reached statistical significance for predicting all three outcomes. Conclusions: A baseline sGMI ≥2 at diagnosis and day 7 sGMI ≥1.5 can be used as a universal prognostic marker for IPA outcomes. erj;66/suppl_69/PA1746/F1 F1 F1

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